Responding to the needs of people who inject drugs in prison

Up to 50% of people in prison use or inject drugs. In prison, unsafe drug injecting practices are a major risk factor for the transmission of blood-borne infections such as HIV and hepatitis C. The frequency of multi-use needles and syringes is documented as very high among people who inject drugs in prisons.

The evidence base for harm reduction is strong and consistent; however, such programmes are rarely implemented in prisons. Political, legal and regulatory barriers hinder the introduction or expansion of harm reduction programmes in prisons. By 2017, opioid substitution therapy (OST) was available in prisons in only 56 countries and only 11 countries implemented needle and syringe programmes (NSP) in prisons.

The burden of hepatitis C among people in prison is a major public health concern. The global response to hepatitis C in closed settings has been limited, with few countries implementing the necessary preventive interventions or providing treatment for people with hepatitis C in prison. Greater attention towards hepatitis C prevention, diagnosis, and effective delivery of treatment to detained populations is urgently required.

What we do:

Supporting the revision, adaptation, development and implementation of effective legislation, policies and strategies

UNODC works to advance national dialogues and advocacy for harm reduction programmes for people who use drugs in prison. 

Development and dissemination of normative guidance on harm reduction programmes and HIV service provision for people who inject drugs in prison

UNODC developed a handbook to provide information and practical guidance to support the implementation of NSP in prisons and other closed settings.

UNODC also developed a training manual for law enforcement of­ficials on HIV service provision for people who inject drugs.

Capacity building

UNODC supported implementation of the first opioid substitution therapy (OST) unit for prisoners in Phu Son Prison in Vietnam, marking a significant milestone in HIV prevention, treatment and care in prison settings in the country.

OST is also now available in the Tihar Prisons complex in India.

The Republic of Moldova is one of the few countries in the world that provides the comprehensive package in prisons. This has resulted in a marked decrease in the prevalence of HIV and HCV. The NSP in Moldova was initially piloted in one prison and gradually extended to 13 prisons in 2014, an average of 90,000 syringes are distributed annually. OST is also available in 13 prisons.

Technical assistance

UNODC supports the development and implementation of comprehensive evidence-based interventions for HIV prevention, treatment and care in prison.

Advocacy

UNODC promotes human rights-based, gender responsive, public health-centered and evidence-based approaches, elimination of stigma, discrimination and violence.